For women who ought to get a mammogram, but are inclined to avoid making an appointment due to the inconvenience or worries about what the screening might disclose, UPMC oncological breast surgeon Meaghan Marley has some statistics.

— The survival rate after five years following discovery and treatment of breast cancer that hasn’t spread outside the breast in which it is located is “essentially 100 percent,” Marley said in a phone interview Friday occasioned by October’s being Breast Cancer Awareness Month.

— The survival rate after five years following discovery and treatment of breast cancer that has become “regional” by spreading into the lymph nodes is 87%.

— And the survival rate after five years following discovery and treatment after breast cancer has spread to other parts of the body to become a “distant metastatic disease” is just 32%.

“When found early, the prognosis is so much better,” Marley said.

Mammograms can detect cancers less than a centimeter in diameter — the size of a pea or smaller, Marley said.

When such cancers are deep inside the breast, there’s no way to feel them, and they generally don’t produce symptoms, according to Marley.

Discovering them at that point via screening, however, can mean smaller surgeries, fewer surgeries, possibly no need for lymph node surgery and smaller and fewer treatments like radiation and medical therapies — including chemotherapy and those that operate on the hormonal or protein levels, Marley said.

Women with small tumors can choose to get a lumpectomy, leaving the rest of the breast, although those must be followed by radiation treatments; or choose to get a mastectomy, which removes the breast, after which radiation is usually not necessary, Marley said.

For larger tumors, a mastectomy is often required.

Women at average risk should get yearly mammograms starting at age 40, according to Marley.

Those with a family member diagnosed with breast cancer when young should consider starting mammograms at an age 10 years younger than their relative was when diagnosed, Marley said.

Women with dense breast tissue, as determined by their first mammogram, should get a 3D mammogram — although most mammograms nowadays are 3D anyway, Marley said.

Women with dense breast tissue may also qualify for additional testing by ultrasound, she said.

Dense breast tissue increases the risk of breast cancer, Marley said.

Mammograms and ultrasound testing can be coordinated to occur one after another to minimize inconvenience, she said.

Women can stop getting regular mammograms when they’re 10 years short of their expected life span, Marley said.

“But I hate that recommendation,” she said. “It’s very morbid.”

She prefers to recommend that women get regular mammograms until reaching an age when they wouldn’t bother with treatment upon a negative result, Marley said.

She has treated 90-year-olds who were otherwise healthy and seemed capable of living another 20 years, she said.

As a breast surgeon, Marley has had “a lot of hard conversations” with patients.

But her work has enabled her to see such patients through their crises, after surgeries, treatment plans and recovery, she said.

She has seen them thrive following cancer, she said.

“(They’re) incredibly strong women,” she said.

One “champion” patient came to Marley in her 40s, “scared” after detecting a mass in one of her breasts.

It was confirmed as cancer by a mammogram, followed by a needle biopsy.

Six months of chemotherapy followed.

It was “rough,” with “awful side effects,” Marley said.

A mastectomy followed that, revealing that the chemo had melted away the tumor altogether, she said.

Even when there is an indication that chemo has eliminated tumors, the standard of care calls for a mastectomy, at least for now, Marley said.

The woman is doing well and is cancer-free, according to Marley.

There are cases in which women are found to have a gene mutation in the BRCA1 or the BRCA2 genes that tend to increase the chance of some types of cancer, including breast cancer, according to komen.org.

BRCA genes play a role in repairing damaged DNA and preventing cancer, according to an online source.

The lifetime risk of breast cancer for women in the general population is 13%, according to the komen website.

The lifetime risk for women who’ve inherited the BRCA1 gene mutation is 60% to 70%.

The lifetime risk for women who have the BRCA2 gene mutation is 55% to 70%.

Such patients may want to discuss the option of preventive mastectomies, Marley said.

Mirror Staff Writer William Kibler is at 814-949-7038.